Department of Medical Microbiology, Faculty of Medicine, Baskent University, Ankara, Turkey.
Diagn Microbiol Infect Dis. 2013 Jul;76(3):335-8. doi: 10.1016/j.diagmicrobio.2013.04.004. Epub 2013 May 29.
Carbapenem resistance due to OXA-48 enzymes in Klebsiella pneumoniae is increasing particularly in the Middle Eastern and European regions. Treatment options are limited. The aim of this study was to evaluate the in vitro synergistic activity of fosfomycin in combination with imipenem, meropenem, colistin and tigecycline against OXA-48 producing K. pneumoniae strains. Twelve carbapenem-resistant OXA-48 producing K. pneumoniae isolates were enrolled in this study. Synergistic activity of fosfomycin combined with imipenem, meropenem, colistin, and tigecycline was assessed by chequerboard method. The combination of fosfomycin was synergistic with imipenem, meropenem and tigecycline with the ratios of 42%, 33%, and 33%, respectively. Whilst the combination of fosfomycin with colistin was fully antagonistic against all of the strains, there was no statistically significant difference between the in vitro synergistic activities of fosfomycin in combination with imipenem, meropenem and tigecycline combinations (P > 0.05). Fosfomycin in combination with other agents can be preferred against multidrug resistant K. pneumoniae strains.
产 OXA-48 酶的肺炎克雷伯菌对碳青霉烯类药物的耐药性日益增加，尤其在中东和欧洲地区。治疗选择有限。本研究旨在评估磷霉素与亚胺培南、美罗培南、多粘菌素和替加环素联合应用对产 OXA-48 肺炎克雷伯菌的体外协同活性。本研究纳入了 12 株耐碳青霉烯类药物产 OXA-48 肺炎克雷伯菌。采用棋盘微量稀释法评估磷霉素与亚胺培南、美罗培南、多粘菌素和替加环素联合应用的协同活性。结果显示，磷霉素与亚胺培南、美罗培南和替加环素的组合分别具有 42%、33%和 33%的协同作用。而磷霉素与多粘菌素的组合对所有菌株均呈完全拮抗作用，磷霉素与亚胺培南、美罗培南和替加环素联合应用的体外协同活性无统计学差异（P＞0.05）。因此，磷霉素联合其他药物可作为多药耐药肺炎克雷伯菌的治疗选择。
